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Riechmann-Wolf M, Hegewald J, Jankowiak S, Prigge M, Rossnagel K, Drössler S, Nübling M, Romero Starke K, Seidler A, Schulz A, Zahn D, Münzel T, Pfeiffer N, Wild PS, Beutel ME, Gianicolo E, Lackner KJ, Letzel S. Fühlen sich Beschäftigte bei ihrer beruflichen
Rückkehr nach längerer Arbeitsunfähigkeit von ihrem
Arbeitgeber unterstützt? Welche Rolle spielt die
Unternehmensgröße? Ergebnisse aus einer Pilotbefragung innerhalb
der Gutenberg-Gesundheitsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Riechmann-Wolf
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Arbeits-, Sozial- und Umweltmedizin, Mainz,
Deutschland
| | - J Hegewald
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - S Jankowiak
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - M Prigge
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - K Rossnagel
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - S Drössler
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - M Nübling
- Freiburger Forschungsstelle für Arbeitswissenschaften GmbH
(FFAW), Freiburg, Deutschland
| | - K Romero Starke
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - A Seidler
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - A Schulz
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - D Zahn
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - T Münzel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - N Pfeiffer
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - PS Wild
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - ME Beutel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - E Gianicolo
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - KJ Lackner
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - S Letzel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Arbeits-, Sozial- und Umweltmedizin, Mainz,
Deutschland
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Präv. Kardiologie und Med. Prävention, Zentrum
für Kardiologie, Mainz, Deutschland
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Wicke FS, Ernst M, Otten D, Werner A, Dreier M, Brähler E, Tibubos AN, Reiner I, Michal M, Wiltink J, Münzel T, Lackner KJ, Pfeiffer N, König J, Wild PS, Beutel ME. The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Affiliation(s)
- F S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany.
| | - M Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - D Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - I Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
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3
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Fleischer T, Ulke C, Speerforck S, Gfesser T, Mühlan H, Glaesmer H, Fegert JM, Zenger M, Ladwig KH, Beutel ME, Brähler E, Schomerus G. East vs. West: Differences in the prevalence of child maltreatment in Germany before the reunification. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- T Fleischer
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald
| | - C Ulke
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - S Speerforck
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - T Gfesser
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
| | - H Mühlan
- Health & Prevention, Institute of Psychology, University of Greifswald
| | - H Glaesmer
- Department of Medical Psychology and Medical Sociology, University of Leipzig
| | - JM Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal
| | - K-H Ladwig
- Institute of Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg
| | - ME Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz
| | - G Schomerus
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center
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Wölfling K, Duven E, Wejbera M, Beutel ME, Müller KW. Discounting delayed monetary rewards and decision making in behavioral addictions - A comparison between patients with gambling disorder and internet gaming disorder. Addict Behav 2020; 108:106446. [PMID: 32408114 DOI: 10.1016/j.addbeh.2020.106446] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022]
Abstract
Behavior addictions, such as Gambling Disorder and Internet Gaming Disorder, have been demonstrated to have severe negative impact. Heightened impulsivity, deficits in decision making, and cognitive biases in the preference of immediate rewards have been shown to be crucial aspects in addictive disorders. While for Gambling Disorder (GD), dysfunctional decision making has been documented before, data for Internet Gaming Disorder (IGD) are still underrepresented. In order to allow for a direct comparison of both disorders, we assessed different measures of impulsivity (trait, impulsive choice, and decision making) in a clinical sample. N = 31 patients meeting criteria for GD and n = 30 patients with IGD were recruited from an outpatient clinic and compared regarding their performance in a Delay Discounting Task (DDT), the Iowa Gambling Task (IGT), and self-report data on impulsivity (Barratt Impulsiveness Scale). Healthy controls (n = 27) were included as a reference group. In the DDT, the area under the curve was associated with the severity of GD only. No correlations were found for the impulsivity subscales and the area under the curve which, however, was similar between the two patient groups in contrast to controls. The GD-group performed poorer then the other groups in the IGT while IGD-patients performed poorer only at the beginning of the experiment. Although only few significant differences occurred, similarities between GD and IGD regarding the DDT point towards a tendency on discounting rewards faster. Likewise, both patient groups were performing worse in the IGT than healthy controls which indicates deficiencies in decision making. Interestingly, the IGD-group was able to shift towards more advantageous decision making, which might have important implications for therapeutic interventions.
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Affiliation(s)
- K Wölfling
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - E Duven
- Praxengemeinschaft Gonsenheim, Kapellenstraße 7, 55124 Mainz, Germany
| | - M Wejbera
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M E Beutel
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - K W Müller
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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5
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Schuster AK, Nickels S, Pfeiffer N, Schmidtmann I, Wild PS, Münzel T, Beutel ME, Lackner KJ, Vossmerbaeumer U. Frequency of cataract surgery and its impact on visual function-results from the German Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 2020; 258:2223-2231. [PMID: 32514772 PMCID: PMC7550321 DOI: 10.1007/s00417-020-04770-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/21/2020] [Accepted: 05/25/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the frequency of cataract surgery in Germany and to evaluate its impact on visual function in an adult population. Methods The population-based Gutenberg Health Study was conducted in Germany with its baseline examination between 2007 and 2012 and a 5-year follow-up examiantion. An ophthalmological examination including slit-lamp examination, ocular biometry, and Scheimpflug imaging was carried out. Overall and age-specific frequencies of unilateral and bilateral cataract surgery within 5 years were computed including the 95% confidential intervals [95%-CI]. Association analyses were conducted to determine social and ocular associated factors using multivariable logistic regression analysis. Vision-related quality of life was assessed using NEI VFQ-25. Results A total of 10,544 people aged 35 to 74 years were bilateral phakic at baseline and had information on lens status at the 5-year examination. Of these, 168 had unilateral cataract surgery (1.6% [1.4–1.9%]), and 448 had bilateral cataract surgery (4.2% [3.9–4.7%]) in the following 5 years. The frequency of cataract surgery increased with age: 45–54-year-old subjects had twice as often cataract surgery (in at least on eye: OR = 2.32) than at age 35–44 years. The frequency further strongly increases with age (55–64 years: OR = 10.5; 65–74 years: OR = 43.8, p < 0.001). Subjects with glaucoma were more likely to have cataract surgery (OR = 2.52, p < 0.001). Visual function increased when undergoing bilateral cataract surgery. Conclusions The frequency of cataract surgery is low at younger ages and increases up to 26% at age 70–74 years. Persons with glaucoma are more likely to undergo cataract surgery at population-based level in Germany. Electronic supplementary material The online version of this article (10.1007/s00417-020-04770-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexander K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany.
| | - S Nickels
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
| | - I Schmidtmann
- Institute of Biomedical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Mainz, Germany
| | - T Münzel
- Center for Cardiology, Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - U Vossmerbaeumer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz, 55131, Germany
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Tibubos AN, Zenger M, Schmalbach B, Beutel ME, Brähler E. Measurement invariance, validation and normative data of the Jenkins Sleep Scale-4 (JSS-4) in the German general population across the life span. J Psychosom Res 2020; 130:109933. [PMID: 31951963 DOI: 10.1016/j.jpsychores.2020.109933] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE As sleep disorders have become a major concern in public health, there is strong need for a brief and sound measure for sleep problems. The purposes of the study were to 1) evaluate factor structure and measurement invariance, 2) validate the scale based on sociodemographic data and distress, and 3) provide norm values for the general population. METHODS In a representative survey of the German population N = 2515 participants (14 to 95 years) filled in the 4-item Jenkins Sleep Scale (JSS-4), sociodemographic questions and the Brief Symptom Inventory-18 (anxiety, depression, somatic symptom load). The JSS-4 was analyzed by principal component analysis, confirmatory and multi-group confirmatory factor analyses. A multiple-indicator-multiple-cause model was tested to investigate the relationship of the JSS-4 to distress and sociodemographic variables. RESULTS The one-factor structure of JSS-4 was confirmed. Given the heterogeneity of facets of sleep problems captured in the four items, internal consistency of the JSS-4 was remarkably high. The JSS-4 was strictly invariant across both sexes, and partially strictly invariant across income groups and individuals living with or without a partner. With regard to the full age range, it showed partial scalar invariance. CONCLUSION Female sex, higher age, living without a partner, lower education, lower income and increased distress were associated with more sleep problems. Calculated normative data of sleep problems allow comparisons of JSS-4 scores stratified by sex and age.
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Affiliation(s)
- A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany; Integrated Research and Treatment Center (IFB) Adiposity Diseases - Behavioral Medicine, Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany.
| | - B Schmalbach
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
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7
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Rezapour J, Nickels S, Schuster AK, Michal M, Münzel T, Wild PS, Schmidtmann I, Lackner K, Schulz A, Pfeiffer N, Beutel ME. Prevalence of depression and anxiety among participants with glaucoma in a population-based cohort study: The Gutenberg Health Study. BMC Ophthalmol 2018; 18:157. [PMID: 29954361 PMCID: PMC6022512 DOI: 10.1186/s12886-018-0831-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/20/2018] [Indexed: 01/17/2023] Open
Abstract
Background To investigate the prevalence of depression and anxiety among subjects with self-reported glaucoma and the association between self-reported glaucoma and depression respectively anxiety in a European cohort. Methods A study sample of 14,657 participants aged 35 to 74 years was investigated in a population-based cohort study. All participants reported presence or absence of glaucoma. Ophthalmological examinations were carried out in all participants and demographic and disease related information were obtained by interview. Depression was assessed with the Patient Health Questionnaire (PHQ-9), and generalized anxiety with the two screening items (GAD-2) of the short form of the GAD-7 (Generalized Anxiety Disorder-7 Scale). Prevalence of depression and generalized anxiety were investigated for subjects with and without self-reported glaucoma. Logistic regression analyses with depression, respectively anxiety as dependent variable and self-reported glaucoma as independent variable were conducted and adjusted for socio-demographic factors, systemic comorbidities (arterial hypertension, myocardial infarction, stroke, diabetes mellitus, chronic obstructive pulmonary disease, cancer), ocular diseases (cataract, macular degeneration, corneal diseases, diabetic retinopathy), visual acuity, intraocular pressure, antiglaucoma eye drops (sympathomimetics, parasympathomimetics, carbonic anhydrase inhibitors, beta-blockers, prostaglandins) and general health status. Results 293 participants (49.5% female) reported having glaucoma. Prevalence of depression among participants with and without self-reported glaucoma was 6.6% (95%-CI 4.1–10.3) respectively 7.7% (95%-CI 7.3–8.2), and for anxiety 5.3% (95%-CI 3.1–8.7) respectively 6.6% (95%-CI 6.2–7.1). Glaucoma was not associated with depression (Odds ratio 1.10, 95%-CI 0.50–2.38, p = 0.80) or anxiety (1.48, 95%-CI 0.63–3.30, p = 0.35) after adjustment for socio-demographic factors, ocular/systemic diseases, ocular parameters, antiglaucoma drugs and general health status. A restriction to self-reported glaucoma cases either taking topical antiglaucoma medications or having a history of glaucoma surgery did not alter the result. Conclusions This is the first study analyzing both depression and anxiety among glaucoma patients in a European cohort. Subjects with and without self-reported glaucoma had a similar prevalence of depression and anxiety in our population-based sample. Self-reported glaucoma was not associated with depression or anxiety. A lack of a burden of depressive symptoms may result from recruitment from a population-based sample as compared to previous study groups predominantly recruited from tertiary care hospitals.
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Affiliation(s)
- J Rezapour
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
| | - S Nickels
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - A K Schuster
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - T Münzel
- Center for Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine / Center for Cardiology, University Medical Center Mainz, Mainz, Germany.,Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany.,German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - I Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - K Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - A Schulz
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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Faber J, Wingerter A, Neu MA, Henninger N, Eckerle S, Münzel T, Lackner KJ, Beutel ME, Blettner M, Rathmann W, Peters A, Meisinger C, Linkohr B, Neuhauser H, Kaatsch P, Spix C, Schneider A, Merzenich H, Panova-Noeva M, Prochaska JH, Wild PS. Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy026] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- J Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - A Wingerter
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - M A Neu
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - N Henninger
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - S Eckerle
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - T Münzel
- Center for Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - M E Beutel
- Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M Blettner
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany
| | - W Rathmann
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany
| | - A Peters
- German Center for Cardiovascular Disease Research (DZHK), Partner Site Munich, Technical University of Munich, Biedersteiner Straße 29, 80802 Munich, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- Institute for Cardiovascular Prevention, Ludwig-Maximilian-University Hospital, Pettenkoferstraße 9, 80336 Munich, Germany
| | - C Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - B Linkohr
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - H Neuhauser
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Nordufer 20, 13353 Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - P Kaatsch
- German Childhood Cancer Registry (GCCR), Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany
| | - C Spix
- German Childhood Cancer Registry (GCCR), Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany
| | - A Schneider
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany
| | - H Merzenich
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131 Mainz, Germany
| | - M Panova-Noeva
- Center for Thrombosis and Haemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - J H Prochaska
- German Center for Cardiovascular Research (DZHK) Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Centre for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - P S Wild
- German Center for Cardiovascular Research (DZHK) Partner Site Rhine-Main, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Translational Vascular Biology (CTVB), University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Preventive Cardiology and Preventive Medicine, Centre for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
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Zeissig SR, Weyer-Elberich V, Emrich K, Binder H, Fischbeck S, Imruck BH, Friedrich-Mai P, Beutel ME, Blettner M. Recruiting former melanoma patients via hospitals in comparison to office-based dermatologists in a register-based cohort study that required indirect contact. BMC Med Res Methodol 2017; 17:150. [PMID: 29166870 PMCID: PMC5700464 DOI: 10.1186/s12874-017-0425-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 11/14/2017] [Indexed: 11/17/2022] Open
Abstract
Background There are detailed reviews about different recruitment strategies, but not with regard to differences between recruitment of hospital-based versus office-based physicians. Within this study, the two different recruitment schemes are compared. Advantages and disadvantages of different ways of recruitment in registry-based studies are discussed. Methods In a cross-sectional cancer-registry-based study, long-term melanoma patients were contacted by dermatologists rather than directly by the registry on the basis of the legal situation. Logistic regression models and generalized estimating equations were used to assess effects of various patient and physician characteristics on participation and data quality. Especially differences between hospital-based versus office-based dermatologists are evaluated. Results Seventy two out of 112 contacted dermatologists took part in the study (64.3%). The cooperation proportion was 52.2% (689 participants/1320 contacted patients). Participants and non-participants differed regarding age and sex, but not regarding other social demographic factors and cancer stage. We did not observe a difference in patient participation between hospital-based versus office-based dermatologists (OR 1.08 [CI 0.84–1.39]; p = 0.57). However, medical data provided by the cancer registry were better for participants registered and recruited by hospitals. Conclusions In cohort studies with epidemiological cancer registries, recruitment via physicians has potential disadvantages and is more complex. If this indirect way of contact is mandatory, we recommend recruitment procedures including hospital-based rather than office-based physicians. However, physician characteristics were not associated with outcome.
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Affiliation(s)
- S R Zeissig
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany. .,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - V Weyer-Elberich
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - K Emrich
- Cancer Registry of Rhineland-Palatinate, Grosse Bleiche 46, 55116, Mainz, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - H Binder
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - S Fischbeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - B H Imruck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P Friedrich-Mai
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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10
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Rose DM, Seidler A, Nübling M, Latza U, Brähler E, Klein EM, Wiltink J, Michal M, Nickels S, Wild PS, König J, Claus M, Letzel S, Beutel ME. Associations of fatigue to work-related stress, mental and physical health in an employed community sample. BMC Psychiatry 2017; 17:167. [PMID: 28476149 PMCID: PMC5420158 DOI: 10.1186/s12888-017-1237-y] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/10/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND While work-related fatigue has become an issue of concern among European employees, the relationship between fatigue, depression and work-related stressors is far from clear. The purposes of this study were (1) to determine the associations of fatigue with work-related stressors, severe medical disease, health behavior and depression in the working population and (2) to determine the unique impact of work-related stressors on fatigue. METHODS We used cross-sectional data of N = 7,930 working participants enrolled in the Gutenberg Health Study (GHS) from 2007 to 2012 filled out the Personal Burnout Scale (PBS) of the Copenhagen Psychosocial Questionnaire (COPSOQ), the PHQ-9, and a list of work-related stressors. RESULTS A total of 27.5% reported increased fatigue, esp. women, younger persons with a lower social status and income, smokers, severely medically ill, previously and currently depressed participants. Fatigue was consistently associated with severe medical disease, health behavior and depression, which need to be taken into account as potential confounders when analyzing its relationship to work-related strains. Depression was consistently associated with work-related stressors. However, after statistically partialling out depression, fatigue was still significantly associated with work-related stress. CONCLUSIONS Fatigue as an indicator of allostatic load is consistently associated with work-related stressors such as work overload after controlling for depression. The brief Personal Burn-out Scale is suitable for assessing work-related fatigue in the general population.
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Affiliation(s)
- D. M. Rose
- grid.410607.4Institute of Teachers’ Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - A. Seidler
- 0000 0001 2111 7257grid.4488.0Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - M. Nübling
- FFAW, Freiburg Research Centre for Occupational Sciences, Freiburg, Germany
| | - U. Latza
- 0000 0001 2220 0888grid.432860.bFederal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - E. Brähler
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - E. M. Klein
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - J. Wiltink
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. Michal
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - S. Nickels
- grid.410607.4Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - P. S. Wild
- grid.410607.4Department of Medicine 2, Preventive Cardiology and Preventive Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany ,grid.452396.fGerman Center for Cardiovascular Research (DZHK), partner site RhineMain, Berlin, Germany ,grid.410607.4Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - J. König
- grid.410607.4Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. Claus
- grid.410607.4Institute of Teachers’ Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - S. Letzel
- grid.410607.4Institute of Occupational, Social and Environmental Health, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - M. E. Beutel
- grid.410607.4Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Müller KW, Dreier M, Beutel ME, Wölfling K. Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction. Psychiatry Res 2016; 242:319-325. [PMID: 27322843 DOI: 10.1016/j.psychres.2016.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 06/02/2016] [Accepted: 06/05/2016] [Indexed: 01/14/2023]
Abstract
Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-machine gambling vs. high arousal gambling activities and internet gaming disorder vs. other internet-related addictive behaviors). Decreased scores in some subscales of Sensation Seeking were found among male patients compared to healthy controls with no differences between patients with Gambling Disorder and Internet Addiction. The type of preferred gambling or online activity was not related to differences in Sensation Seeking. Previous findings indicating only small associations between Sensation Seeking and Gambling Disorder were confirmed. Regarding Internet Addiction our results contradict findings from non-clinical samples. Sensation Seeking might be relevant in initiating contact to the health care system.
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Affiliation(s)
- K W Müller
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
| | - K Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, Outpatient Clinic for Behavioural Addictions, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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12
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Müller KW, Janikian M, Dreier M, Wölfling K, Beutel ME, Tzavara C, Richardson C, Tsitsika A. Regular gaming behavior and internet gaming disorder in European adolescents: results from a cross-national representative survey of prevalence, predictors, and psychopathological correlates. Eur Child Adolesc Psychiatry 2015; 24:565-74. [PMID: 25189795 DOI: 10.1007/s00787-014-0611-2] [Citation(s) in RCA: 222] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/23/2014] [Indexed: 11/28/2022]
Abstract
Excessive use of online computer games which leads to functional impairment and distress has recently been included as Internet Gaming Disorder (IGD) in Section III of the DSM-5. Although nosological classification of this phenomenon is still a matter of debate, it is argued that IGD might be described best as a non-substance-related addiction. Epidemiological surveys reveal that it affects up to 3% of adolescents and seems to be related to heightened psychosocial symptoms. However, there has been no study of prevalence of IGD on a multi-national level relying on a representative sample including standardized psychometric measures. The research project EU NET ADB was conducted to assess prevalence and psychopathological correlates of IGD in seven European countries based on a representative sample of 12,938 adolescents between 14 and 17 years. 1.6% of the adolescents meet full criteria for IGD, with further 5.1% being at risk for IGD by fulfilling up to four criteria. The prevalence rates are slightly varying across the participating countries. IGD is closely associated with psychopathological symptoms, especially concerning aggressive and rule-breaking behavior and social problems. This survey demonstrated that IGD is a frequently occurring phenomenon among European adolescents and is related to psychosocial problems. The need for youth-specific prevention and treatment programs becomes evident.
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Affiliation(s)
- K W Müller
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131, Mainz, Germany,
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13
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Michal M, Prochaska JH, Ullmann A, Keller K, Gobel S, Coldewey M, Münzel T, Wiltink J, Beutel ME, Wild PS. Relevance of depression for anticoagulation management in a routine medical care setting: results from the ThrombEVAL study program. J Thromb Haemost 2014; 12:2024-33. [PMID: 25292317 DOI: 10.1111/jth.12743] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 09/07/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Depressive symptoms have detrimental effects on quality of life and mortality. Poor adherence to a treatment regimen is a potential mechanism for the increased risk of adverse medical events associated with depression. Regarding oral anticoagulation with vitamin K antagonists, adherence is crucial for the outcome. Little is known about the clinical relevance of current depressiveness for anticoagulation treatment. OBJECTIVES To examine the impact of current depressiveness on anticoagulation treatment in regular medical care. PATIENTS/METHODS We examined the association between clinically significant depressiveness as assessed by the Patient Health Questionnaire-2 ≥ 2 (PHQ-2 ≥ 2) with the percentage of time in the therapeutic range (TTR), self-rated compliance, several aspects of health literacy, anticoagulation side-effects and treatment satisfaction in a cross-sectional study of 1790 oral anticoagulation outpatients. RESULTS Seven hundred and sixteen participants (40.0%) had clinically significant depressive symptoms. Depressed persons reported lower compliance with intake of prescribed medication and regular visits for control of anticoagulation, more unspecific side-effects (e.g. pruritus) and lower satisfaction with the anticoagulation treatment and their doctors' expertise and empathy. Depressed as compared with non-depressed individuals had a lower TTR (-4.67; 95% CI, -8.39 to -0.95). Increasing severity of depressiveness was related with decreasing TTR. However, depressiveness lost its significant impact on TTR after multivariable adjustment (-3.11; 95% CI, -6.88 to 0.66). CONCLUSIONS Clinically significant depressiveness was highly prevalent and impaired several aspects of anticoagulation treatment. Depressiveness should be regarded as a clinically significant condition that needs to be addressed in the management of anticoagulation patients.
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Affiliation(s)
- M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
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14
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Wölfling K, Beutel ME, Dreier M, Müller KW. Treatment outcomes in patients with internet addiction: a clinical pilot study on the effects of a cognitive-behavioral therapy program. Biomed Res Int 2014; 2014:425924. [PMID: 25097858 PMCID: PMC4100341 DOI: 10.1155/2014/425924] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 05/26/2014] [Indexed: 02/07/2023]
Abstract
Internet addiction is regarded as a growing health concern in many parts of the world with prevalence rates of 1-2% in Europe and up to 7% in some Asian countries. Clinical research has demonstrated that Internet addiction is accompanied with loss of interests, decreased psychosocial functioning, social retreat, and heightened psychosocial distress. Specialized treatment programs are needed to face this problem that has recently been added to the appendix of the DSM-5. While there are numerous studies assessing clinical characteristics of patients with Internet addiction, the knowledge about the effectiveness of treatment programs is limited. Although a recent meta-analysis indicates that those programs show effects, more clinical studies are needed here. To add knowledge, we conducted a pilot study on the effects of a standardized cognitive-behavioral therapy program for IA. 42 male adults meeting criteria for Internet addiction were enrolled. Their IA-status, psychopathological symptoms, and perceived self-efficacy expectancy were assessed before and after the treatment. The results show that 70.3% of the patients finished the therapy regularly. After treatment symptoms of IA had decreased significantly. Psychopathological symptoms were reduced as well as associated psychosocial problems. The results of this pilot study emphasize findings from the only meta-analysis conducted so far.
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Affiliation(s)
- K. Wölfling
- Outpatient Clinic for Behavioral Addictions, Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M. E. Beutel
- Outpatient Clinic for Behavioral Addictions, Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M. Dreier
- Outpatient Clinic for Behavioral Addictions, Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - K. W. Müller
- Outpatient Clinic for Behavioral Addictions, Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
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Müller KW, Beutel ME, Wölfling K. A contribution to the clinical characterization of Internet addiction in a sample of treatment seekers: validity of assessment, severity of psychopathology and type of co-morbidity. Compr Psychiatry 2014; 55:770-7. [PMID: 24602498 DOI: 10.1016/j.comppsych.2014.01.010] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 01/09/2014] [Accepted: 01/14/2014] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Internet addiction becomes a growing health problem worldwide with prevalence rates up to 3%. Still, uncertainties exist regarding its diagnostics and clinical characterization. Especially the lacking clinical evidence regarding self-report measures assessing Internet addiction has been criticized. METHODS This study aimed to characterize 290 German treatment seekers and to determine the diagnostic accuracy of a self-report scale for Internet addiction. Patients filled in self-report measures (SCL-90R, PHQ, AICA-S - Scale for the Assessment of Internet and Computer game Addiction) and underwent diagnostic interviews to assess symptoms of Internet addiction and level of functioning. RESULTS Of the predominantly male treatment seekers 71% met the clinical diagnosis of Internet addiction. These displayed higher levels of psychopathology, especially depressive and dissociative symptoms. Half of the patients met criteria for one further psychiatric disorder according to clinical interviews, especially depressive disorders. Their level of functioning was decreased in all domains. AICA-S showed good psychometric properties and satisfying diagnostic accuracy (sensitivity: 80.5%; specificity: 82.4%). DISCUSSION In this sample, Internet addiction was associated with high levels of psychosocial distress that is mainly related to depressive symptoms. Co-morbid disorders were common among those patients. First analyses on diagnostic accuracy of AICA-S (using the therapist's rating on Internet addiction as an independent external criterion) showed promising results.
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Affiliation(s)
- K W Müller
- Outpatient Clinic for Behavioural Addictions, Department of Psychosomatic Medicine and Psychotherapy of the University Medical Centre of the Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M E Beutel
- Outpatient Clinic for Behavioural Addictions, Department of Psychosomatic Medicine and Psychotherapy of the University Medical Centre of the Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - K Wölfling
- Outpatient Clinic for Behavioural Addictions, Department of Psychosomatic Medicine and Psychotherapy of the University Medical Centre of the Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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Zwerenz R, Hennemann S, Gerzymisch K, Becker J, Beutel ME. [E-health: trends in rehabilitation and psychotherapy - expert meeting of the university medical center, November 23, 2013 in Mainz]. REHABILITATION 2014; 53:133-4. [PMID: 24723065 DOI: 10.1055/s-0034-1370985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- R Zwerenz
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
| | - S Hennemann
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
| | - K Gerzymisch
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
| | - J Becker
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
| | - M E Beutel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz
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Beutel ME, Wiltink J, Kirschner Y, Sinning C, Espinola-Klein C, Wild PS, Münzel T, Blettner M, Zwiener I, Lackner K, Michal M. History of depression but not current depression is associated with signs of atherosclerosis: data from the Gutenberg Health Study. Psychol Med 2014; 44:919-925. [PMID: 23822954 DOI: 10.1017/s0033291713001542] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To test the vascular depression hypothesis in the general population, we analyzed the association between current depression, medical history of depression, cognitive and somatic depressive symptom dimensions and measures of atherosclerosis [intima-media thickness (IMT) and carotid plaques]. METHOD We included a representative sample of 5000 participants from the Gutenberg Health Study (GHS). Depression was assessed by the nine-item Patient Health Questionnaire (PHQ-9), and IMT and carotid plaques were measured at both common carotid arteries using an edge detection system. Regression analyses were performed separately for participants with and without cardiovascular disease, adjusting for medical history, cardiovascular risk factors and psychotropic medication. RESULTS Contrary to hypotheses, we found no increased IMT for somatic symptoms of depression; the same was true for depression and cognitive symptoms in the fully adjusted model. Only a moderate relationship between medical history of depression and the presence of atherosclerotic plaques was maintained after correction. CONCLUSIONS The relationship between depression and atherosclerosis may be more complex than previously assumed. Although the vascular depression hypothesis was not supported, our results support the hypothesis that lasting depression leads to arteriosclerosis.
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Affiliation(s)
- M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Y Kirschner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - C Sinning
- Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany
| | - C Espinola-Klein
- Department of Medicine II, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - P S Wild
- Department of Medicine II, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - T Münzel
- Department of Medicine II, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - M Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - I Zwiener
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - K Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Zimmermann A, Zwerenz R, Droste M, Schöfl C, Strasburger CJ, Plöckinger U, Honneger J, Dixius A, Beutel ME, Weber MM. Personality traits in patients with active and controlled acromegaly: A cross sectional multi-center study. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Müller KW, Beutel ME, Egloff B, Wölfling K. Investigating risk factors for Internet gaming disorder: a comparison of patients with addictive gaming, pathological gamblers and healthy controls regarding the big five personality traits. Eur Addict Res 2014; 20:129-36. [PMID: 24247280 DOI: 10.1159/000355832] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/10/2013] [Indexed: 12/20/2022]
Abstract
Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients meeting the criteria for IGD were compared to 167 control subjects displaying either regular or intense use of online games. Additionally, 115 patients meeting diagnostic criteria for pathological gambling were included. IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion. The comparisons to pathological gamblers indicate that low conscientiousness and low extraversion in particular are characteristic of IGD. An integration of personality variables into an etiopathological model describing presumable mechanisms fostering and maintaining addictive online gaming is proposed. This model could be helpful for the theoretical understanding of addictive gaming, public health campaigns and psychoeducation within therapeutic settings.
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Affiliation(s)
- K W Müller
- Outpatient Clinic for Behavioural Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
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Beutel ME, Weißflog G, Leuteritz K, Wiltink J, Haselbacher A, Ruckes C, Kuhnt S, Barthel Y, Imruck BH, Zwerenz R, Brähler E. Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial. Ann Oncol 2013; 25:378-84. [PMID: 24347520 DOI: 10.1093/annonc/mdt526] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer. PATIENTS AND METHODS In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N=78) or 'treatment as usual' (control group, TAU, N=79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL). RESULTS In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR=7.64; P<0.001) was the strongest predictor for remission post-treatment; time was also significant (OR=0.96; P<0.05). A high effect favoring STPP (d=0.82) was observed for the HADS-D score post-treatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d=0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss. CONCLUSIONS STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (∼1/3) and delayed post-treatment assessments. Future trials may consider stepped-care approaches, tailored to patients' needs and requirements in the acute treatment phase.
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Affiliation(s)
- M E Beutel
- Department for Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz
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Ebenhan K, Leuteritz K, Barthel Y, Beutel ME, Papsdorf K, Weissflog G, Brähler E. Children and Employment - Resource or Stressors after Breast Cancer? Geburtshilfe Frauenheilkd 2013; 73:792-799. [PMID: 24771933 PMCID: PMC3858982 DOI: 10.1055/s-0033-1350704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 06/10/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022] Open
Abstract
Introduction: Breast cancer patients suffer clinically relevant levels of psychological stress because of their disease. Various factors can affect the level of stress experienced. This study aimed to investigate the relationship between the level of psychological stress and employment and children, including time since diagnosis. Material and Methods: A randomised clinical study was done of 724 breast cancer patients aged between 18 and 65 years; all were in the curative stage of disease and had been diagnosed 0-12 months previously. Patients were investigated for their levels of psychological stress (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS). The relationship between anxiety and depression and the variables "employment", "parenthood" and "time since diagnosis" were investigated, using univariate and multivariate analysis. Results: Patients with a longer time since diagnosis (4-12 months) were found to have lower levels of anxiety (6.28) compared to patients who had been diagnosed only 0-3 months previously (7.24; p < 0.01). There was no unambiguous relation between parenthood and anxiety. The age of the children was crucial. Even when results were controlled for patient age, the anxiety levels of women with children below the age of 16 years were significantly higher (7.84) compared to patients without children (6.42) or patients whose children were older than 16 years (6.87; p = 0.04). Women who were not employed had significantly higher levels of depression compared to all other participants in the study (p = 0.02). No reciprocal effects were found between investigated variables. Conclusion: We found a differentiated relationship between the variables "time since diagnosis", "employment" and "children" and the level of psychological stress experienced by breast cancer patients. When determining the level of psychological stress in the 1st year after diagnosis, particular attention should be paid to patients who are not employed and patients with children below the age of 16 years.
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Affiliation(s)
- K Ebenhan
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - K Leuteritz
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - Y Barthel
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - M E Beutel
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Psychosomatische Medizin , und Psychotherapie, Mainz
| | - K Papsdorf
- Universitätsklinikum Leipzig AöR, Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Leipzig
| | - G Weissflog
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
| | - E Brähler
- Department für Psychische Gesundheit, Abteilung für Medizinische Psychologie und Medizinische Soziologie , Universitätsklinikum Leipzig AöR, Leipzig
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Beutel ME, Wiltink J, Till Y, Wild PS, Münzel T, Ojeda FM, Zeller T, Schnabel RB, Lackner K, Blettner M, Zwiener I, Michal M. Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study. Psychother Psychosom 2012; 81:108-17. [PMID: 22262039 DOI: 10.1159/000331776] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 08/12/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population. METHODS The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study. RESULTS The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety. CONCLUSIONS Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease.
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Affiliation(s)
- M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Wiltink J, Gläsmer H, Canterino M, Wölfling K, Knebel A, Kessler H, Brähler E, Beutel ME. Emotionsregulation in der Allgemeinbevölkerung - Bevölkerungskennwerte des Emotion Regulation Questionnaire (ERQ). Psychother Psych Med 2011. [DOI: 10.1055/s-0031-1272451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Michal M, Blettner M, Till Y, Münzel T, Wiltink J, Blankenberg S, Beutel ME. Differentielle Assoziation kognitiver und somatischer Symptome der Depression mit kardiovaskulärer Morbidität und kardiovaskulären Risikofaktoren - Ergebnisse der Gutenberg-Herz-Studie. Psychother Psych Med 2011. [DOI: 10.1055/s-0031-1272407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Beutel ME, Wiltink J, Till Y, Münzel T, Blankenberg S, Blettner M, Michal M. Die Typ-D Persönlichkeit als ein kardiovaskulärer Risikofaktor in der Allgemeinbevölkerung: - Ergebnisse der Gutenberg Herz-Studie. Psychother Psychosom Med Psychol 2011. [DOI: 10.1055/s-0031-1272360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Canterino M, Beutel ME, Bauerman T, Lichy M, Rahm B, Unterrainer J, Michal M. Verarbeitung emotionaler Stimuli bei Patienten mit chronischer Depersonalisation - differentielle Effekte von Achtsamkeit. Psychother Psych Med 2011. [DOI: 10.1055/s-0031-1272363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Subic-Wrana C, Knebel A, Beutel ME. Mentalisierung bei somatoformen Störungen - Design und erste psychometrische Ergebnisse einer fMRI-Studie. Psychother Psychosom Med Psychol 2011. [DOI: 10.1055/s-0031-1272438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schermuly I, Fellgiebel A, Wagner S, Yakushev I, Stoeter P, Schmitt R, Knickenberg RJ, Bleichner F, Beutel ME. Association between cingulum bundle structure and cognitive performance: an observational study in major depression. Eur Psychiatry 2011; 25:355-60. [PMID: 20621455 DOI: 10.1016/j.eurpsy.2010.05.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 04/30/2010] [Accepted: 05/02/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Major depression can be regarded as a systemic neurobehavioral disorder resulting from dysfunction of the limbic-cortical networks. The cingulum bundle represents a major association fiber tract of those networks. The aim of our study was to determine the association of brain structural tissue markers of the cingulum bundle and cognitive function in patients with major depression. METHODS Region-of-interest-based analyses of the middle-anterior and middle-posterior cingulum bundle fractional anisotropy (FA) and mean diffusivity (MD) using color-coded diffusion-tensor imaging and neuropsychological assessment in 14 patients with major depression. RESULTS FA of the middle-anterior and middle-posterior cingulum bundle was significantly correlated to the performance in a planning and divided attention task. Furthermore, MD of the middle-posterior cingulum bundle was significantly correlated to a planning task. There was no significant correlation between FA and MD of the cingulum bundle and selective attention or memory. CONCLUSIONS Brain structural tissue markers of the middle-anterior and middle-posterior cingulum bundle were found to be associated with executive functioning and divided attention in patients with major depression. Disconnection within the limbic-cortical networks may underlay cognitive dysfunction in major depression.
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Affiliation(s)
- I Schermuly
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
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Wiltink J, Beutel ME, Brähler E, Weidner W. Hypogonadism-related symptoms: development and evaluation of an empirically derived self-rating instrument (HRS ‘Hypogonadism Related Symptom Scale’). Andrologia 2009; 41:297-304. [DOI: 10.1111/j.1439-0272.2009.00930.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Wagner S, Paulsen S, Bleichner F, Knickenberg RJ, Beutel ME. [Cognitive training in rehabilitation: a program to treat mild cognitive impairment]. Z Gerontol Geriatr 2009; 42:479-87. [PMID: 19543680 DOI: 10.1007/s00391-009-0044-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 05/12/2009] [Indexed: 11/25/2022]
Abstract
As part of a research project, a behavior therapy-oriented cognitive training program, designed to improve the cognitive ability of middle-aged employees (50 to 59 years), was implemented and evaluated. The goal of the training program was to analyze the cognitive, affective and behavior-related conditions of memory deficits in the workplace. The training focused on two topics: (1) development of new job tasks, (2) lack of time and deadline constraints. A total of 316 patients in the psychosomatic clinic of Bad Neustadt participated in the study. Those who showed cognitive impairments took part in the cognitive training program during the intervention phase. During the control phase, patients with cognitive impairments received no additional intervention. The neuropsychological screening was repeated with patients with cognitive impairments at discharge. The findings show that the objective and subjective memory performance of the participants improved significantly compared to that of the control group. At the 1-year follow-up, 84% of the participants reported that they could use the training strategies in their job.
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Affiliation(s)
- S Wagner
- Klinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität, Untere Zahlbacher Strasse 8, 55131, Mainz, Deutschland.
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de Zwaan M, Herpertz S, Hilbert A, Zipfel S, Beutel ME, Gefeller O, Mühlhans B. Erfolgreicher und anhaltender Gewichtsverlust in einer repräsentativen Stichprobe der Deutschen Allgemeinbevölkerung. Psychother Psychosom Med Psychol 2009. [DOI: 10.1055/s-0029-1208211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Michal M, Tschan R, Beutel ME, Zwerenz R. Die 2-Itemversion der Cambridge Depersonalization Scale. Psychother Psych Med 2009. [DOI: 10.1055/s-0029-1208163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Subic-Wrana C, Knebel A, Beutel ME, Lane R. Zusammenhang zwischen Differenzierung im Emotionserleben und Mentalsierungsfähigkeit bei Patienten mit somatoformen Störungen und gesunden Kontrollen. Psychother Psychosom Med Psychol 2009. [DOI: 10.1055/s-0029-1208143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Greif-Higer G, Otto G, Beutel ME. Psychische Langzeitfolgen nach High urgency–Lebertransplantation wegen akutem Leberversagen. Psychother Psychosom Med Psychol 2009. [DOI: 10.1055/s-0029-1208255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Tschan R, Wiltink J, Best C, Bense S, Dieterich M, Beutel ME, Eckhardt-Henn A. Validation of the German version of the Vertigo Symptom Scale (VSS) in patients with organic or somatoform dizziness and healthy controls. J Neurol 2008; 255:1168-75. [DOI: 10.1007/s00415-008-0863-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2007] [Revised: 12/03/2007] [Accepted: 01/08/2008] [Indexed: 11/24/2022]
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Michal M, Beutel ME. Prävalenz und Korrelate von Depersonalisation in Deutschland–eine Repräsentativerhebung. Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dietrich S, Bauermann T, Knebel A, Merten J, Stoeter P, Beutel ME. Subjektives Empfinden, Emotionserkennungsleistung und Hirnaktivierung beim Betrachten von Gesichtern mit emotionalem Ausdruck bei Patienten mit sozialer Phobie. Psychother Psych Med 2008. [DOI: 10.1055/s-2008-1061588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Subic-Wrana C, Knebel A, Wiltink J, Beutel ME. Beziehungen zwischen ungelöstem Bindungstrauma und retrospektiv erinnerter Kindheitstraumatisierung bei Patienten in stationärer psychosomatischer Behandlung. Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schattenburg L, Zwerenz R, Knickenberg RJ, Beutel ME. Dreijahres-Katamnese einer tiefenpsychologischen Gruppentherapie für beruflich belastete Patienten. Psychother Psychosom Med Psychol 2008. [DOI: 10.1055/s-2008-1061599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beutel ME, Wiltink J. Aktueller Stand der Leitlinienentwicklung. Psychother Psych Med 2008. [DOI: 10.1055/s-2008-1061551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hardt J, Beutel ME. Die SCL-90-R als Screening Instrument im Psychosomatischen Konsil- und Liaisondienst. Psychother Psychosom Med Psychol 2007. [DOI: 10.1055/s-2007-970649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beutel ME, Dippel A, Szczepanski M, Thiede R, Wiltink J. Mid-term effectiveness of behavioral and psychodynamic inpatient treatments of severe obesity based on a randomized study. Psychother Psychosom 2007; 75:337-45. [PMID: 17053334 DOI: 10.1159/000095439] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The objective of this study was to compare the effectiveness of psychodynamic and behavioral inpatient treatments of severely obese patients regarding weight and distress. METHODS In a longitudinal study obese patients (body mass index, BMI >or=35) were randomly assigned to behavioral or to psychodynamic inpatient treatment. Mostly female (n = 267; 85%) obese patients with psychiatric and somatic comorbidity (age 20-64 years, BMI 35-74) were examined with standardized self-report scales on distress (SCL-90R), interpersonal problems (Inventory of Interpersonal Problems), eating behavior (Fragebogen zum Essverhalten) and body image (Fragebogen zum Korperbild). RESULTS During 49 days (mean) of inpatient treatment, patients lost an average of 5.6 kg (4.4%) in the behavioral (n = 130) and 5.7 kg (4.4%) in the psychodynamic setting (n = 137). In both settings, eating behavior, well-being and body image also improved significantly. One year after discharge, return rate was 73%. Forty percent had further reduced their weight (by more than 5% compared to intake), 36% had regained weight, but were still below intake level, and another 24% had increased weight above intake. CONCLUSION Behavioral and psychodynamic treatments were equally effective reducing weight and distress over 1 year.
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Affiliation(s)
- M E Beutel
- Clinic of Psychosomatic Medicine and Psychotherapy, Johannes Gutenberg University, Mainz, Germany
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Beutel ME, Hinz A, Albani C, Brahler E. Fatigue assessment questionnaire: standardization of a cancer-specific instrument based on the general population. Oncology 2006; 70:351-7. [PMID: 17179729 DOI: 10.1159/000098108] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2005] [Accepted: 08/05/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Fatigue has become a major issue of concern in the care of cancer patients, as it has been shown to compromise their quality of life in a significant and lasting way. However, there is a lack of economic and specific measures. The Fatigue Assessment Questionnaire (FAQ) has been developed based on thorough interviews and tested on a large mixed sample of cancer patients. The purposes of this paper are to test the psychometric properties of the FAQ and to provide norms for the German population. METHODS The FAQ was administered to a representative sample of the German population (1,340 female and 1,101 male participants) along with standardized scales of depression, mood and life satisfaction. RESULTS We could confirm that fatigue is multidimensional and can be measured by the scales of physical, affective and cognitive fatigue with good reliability and validity. The dependency of fatigue on sex and age makes it useful to have standard fatigue scores for oncological research as provided in this paper. CONCLUSION The FAQ is a promising, differentiated, yet economic instrument for further use in oncological research.
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Affiliation(s)
- M E Beutel
- Klinik und Poliklinik fur Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universitat Mainz, Mainz, Germany.
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Beutel ME, Greif-Higer G, Haselbacher A, Galle PR, Otto G. Einstellungen zur postmortalen Organspende - Ergebnisse einer Repräsentativerhebung der deutschen Bevölkerung. Z Gastroenterol 2006; 44:1135-40. [PMID: 17115354 DOI: 10.1055/s-2006-927126] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The increasing deficit of organs causes a drastic decline in the quality of life and survival of numerous patients in need of a transplantation. The purpose of this representative community study was to survey attitudes toward transplantation in the German population and to identify underlying determinants. Unlike previous surveys, fears and concerns were elicited based on a concrete case vignette. Among the 1,002 participants, 90 % were in favour of organ donation in general; 21 % reported having signed an organ donor card. Consent to organ donation was associated with younger age and higher social class; the same was true for the possession of an organ donor card. In the virtual decision situation, the majority (77 %) voted in favour of an organ donation based on saving lives, consolation for bereaved and the absence of disadvantages for the donor. Common (up to 50 %), however, were also fears and concerns regarding determination of the time of death, displacement of medical concern from the donor to the recipient of the organ, utilisation of organs for other purposes, or explantation before death. The knowledge of the determinants identified, of existing fears and concerns are helpful not only for informing the public, but also for the dialogue with the next of kin of potential donors. Here, it may be helpful not only to address arguments pro organ donation, but also to address potential fears and concerns.
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Affiliation(s)
- M E Beutel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Mainz
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Beutel ME, Klockenbrink P, Wiltink J, Dietrich S, Thiede R, Fan J, Posner MI. Aufmerksamkeit und exekutive Funktionen bei Patienten mit Adipositas per magna. Nervenarzt 2006; 77:1323-4, 1326-31. [PMID: 15976922 DOI: 10.1007/s00115-005-1951-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this paper, attention and temperament are compared between 41 severely obese patients with psychiatric comorbidity and 45 control persons. Networks of attention were assessed by the Attention Network Test: alerting (ability to achieve and maintain an alert state), orienting (ability to orient to a stimulus), and executive attention (ability to resolve conflict). According to hypotheses, obese patients show reduced executive attention, more effortful control, and higher negative affectivity than controls. The concept of attention networks is related to cognitive mechanisms of self-regulation, opening new perspectives for understanding psychiatric disorders.
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Affiliation(s)
- M E Beutel
- Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Johannes-Gutenberg-Universität Mainz
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Wagner S, Kaschel R, Paulsen S, Knickenberg RJ, Bleichner F, Beutel ME. Kognitive Auffälligkeiten, Depressivität und Leistungsfähigkeit bei älteren Arbeitnehmern in stationärer psychosomatischer Behandlung. Nervenarzt 2006; 77:1338-44. [PMID: 16082527 DOI: 10.1007/s00115-005-1973-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Due to aging of the population and a possible rise in retirement age, the cognitive capacity of older people is gaining great importance. As evidenced by the increase in early retirement due to psychosomatic disease, many employees are not capable of working at a higher age. Decreasing cognitive abilities have usually been studied in subjects over 65 years based on the heterogeneous construct of mild cognitive impairment (MCI). This study investigates the prevalence of cognitive impairments in the age group from 50 to 59 years and their reflections in subjective vocational achievement and social medical evaluation. Having been assigned to inpatient rehabilitation due to decreasing work performance, these patients could be considered a risk group for developing MCI. A battery of standardized cognitive tests was conducted with patients at a psychosomatic hospital (Termine Test, CVLT, Block Design, TAP, and Tower of Hanoi). The MCI was defined by performance below the average age norm in at least two of five functional areas. Depression was assessed by the Beck Depression Inventory. Cognitive impairment was observed in 24% of participants. These patients also described vocational difficulties. Cognitive impairments of older employees could possibly be compensated for by specific training programs in order to maintain or rebuild their work capacity.
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Affiliation(s)
- S Wagner
- Klinik für Psychosomatik und Psychotherapie, Justus-Liebig-Univertsität Giessen
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Abstract
Sexual dysfunctions have found an increasing attention in recent epidemiological studies of the ageing male. The purpose of this paper is to review the prevalence of sexual dysfunctions and risk factors based on community samples. Studies have not only demonstrated a strong age-related incline of erectile dysfunction (ED), but also of ejaculatory and orgasmic disorders (particularly a reduced or absent ejaculation). Despite a declining sexual desire, sexual interest remains present in old age. Lower urinary tract symptoms have been identified as strong risk factors for ED along with cardiovascular, metabolic, psychiatric disorders and lifestyle factors. The wide range of prevalence rate estimates is likely because of different definitions and criteria of sexual dysfunctions. More research is needed on other dysfunctions besides ED and on the partner relationship as a major determinant of sexual activity and satisfaction. The interrelationship between risk factors calls for interdisciplinary prevention and treatment approaches. As disability-free life expectancy keeps increasing, the need to identify, adequately assess and treat male sexual dysfunction as an important impediment to quality of life most likely will become even more pressing.
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Affiliation(s)
- M E Beutel
- Clinic and Policlinic for Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany.
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Abstract
Only recently has functional neuroimaging been used increasingly in the context of psychotherapy research. Based on a literature survey, procedures, methodological underpinnings and paradigms relevant for psychotherapy research are explored regarding functional magnetic resonance imaging (fMRI) and positron emission tomography (PET). Current studies on changes of brain functions and potential mechanisms are presented based on obsessive-compulsive disorders, depression, phobia, panic and borderline personality disorders. Findings and implications are discussed regarding the use of functional neuroimaging in psychotherapy research. Systematic changes of brain activation were demonstrated following successful psychotherapy, partially resembling and partially differing from those induced by psychopharmacological treatments. Thus the traditional split between pharmacological procedures "acting on the brain" and psychological procedures making the patient "feel better" has been rendered obsolete. Procedures of functional neuroimaging have been developed to such an extent that they can be used to study issues of great relevance for psychotherapy, e. g. biological underpinnings of psychiatric disorders, plasticity of neural networks, mechanisms of change and prognostic factors of psychotherapy, etc.
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Affiliation(s)
- M E Beutel
- Klinik für Psychosomatische Medizin und Psychotherapie, Johannes Gutenberg-Universität Mainz, Untere Zahlbacher Strasse 8, 55131 Mainz, BRD.
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Wiltink J, Subic-Wrana C, Beutel ME. Die artifizielle Störung. Psychotherapeut 2006. [DOI: 10.1007/s00278-006-0494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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